'Crisis of confidence' in Obamacare

Frustrated Senate Democrats laid into a top Obama administration health official today for the “crisis of confidence” in Obamacare created by the flawed rollout of HealthCare.gov.

Marilyn Tavenner, the administrator of the Centers for Medicare & Medicaid Services, tried to reassure lawmakers that the administration can meet its goal of having the website running by late November. And she said the administration has campaigns ready to encourage young people as well as people who have had their health plans cancelled to give Obamacare a chance.

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“We do have a campaign to reach out to consumers, but we will not start that campaign until we stabilize the site over the next few weeks,” Tavenner said. That will include reminders that people who are losing their current plans may be eligible for subsidies in the new Obamacare health exchanges.

It was the first time a top health official appeared before a Senate panel since the botched launch on Oct. 1, and one Democrat after another voiced frustration and expressed anxiety about how to turn Obamacare around after the disastrous rollout and the avalanche of bad publicity around cancelled health plans. Democrats had for decades sought sweeping health reform legislation but the Affordable Care Act has been politically costly and they have a lot riding on a turnaround.

Among the most blunt was Sen. Barbara Mikulski (D-Md.), who said the enrollment problems that have persisted for more than a month had sparked a “crisis of confidence” particularly about whether enough young and healthy people will enroll once the website is repaired.

Tavenner promised to release enrollment numbers next week and said the administration had hoped for roughly 800,000 enrollees in October and November. CMS Communications Director Julie Bataille later said at a briefing that the targets change as details about the tech challenges emerge. She said the number includes federal and state exchanges, as well as new Medicaid and Children’s Health Insurance Program enrollees.

HELP Committee chairman Tom Harkin (D-Iowa), one of Obamacare’s most ardent supporters, set the tone for the hearing as he tried to balanced his criticisms with his strong support of the health law.He stressed he wanted straight answers on when HealthCare.gov will be working. But he also distinguished between Democrats who wanted to fix the problems — and Republicans who have been intent all along on bringing down the whole law.

“This is a machine that will be fixed,” Harkin said of the website.

“I want to learn today how those problems will be fixed, but herein may be a difference,” he said. “I want it fixed so the Affordable Care Act will succeed, not to be torn down.” He said the Republicans’ years of opposition meant they have “surrendered their right at indignation that it’s not working flawlessly."

Following persistent questioning from Republican lawmakers about whether the public can trust that HealthCare.gov will protect their personal information, Harkin also said the website’s security is of “paramount importance.”

“This is an issue that really has to be focused on thoroughly so there is absolute assurance” of security, he said.

Senate Republicans, who have universally opposed the law from the beginning, kept pounding away at what they see as the law’s myriad problems — cost, access, security and, of course, the website.

GOP Sen. Lisa Murkowski said that only three people had enrolled in the federal exchange in Alaska as of last week — and all three had received incorrect subsidy information. Tavenner said her agency is working on a fix to the problem, which she said is Alaska-specific.

Republican Sen. Lamar Alexander pressed Tavenner on why President Barack Obama promised Americans they can keep their health insurance, even if the administration knew some of those plans would be eliminated by 2014.

Tavenner said the “churn” in individual market policies each year is greater than 50 percent. That means many of these plans would have been eliminated with or without the new health law.

“Take a look at what’s available,” she advised people who have lost their coverage. “Yes, maybe some of those plans are more expensive,” she said. But she said that some people facing cancellations will qualify for subsidies in the new insurance exchanges,and that administration officials are meeting Tuesday to address how to “actively engage” consumers who have received cancellation notices.

“We are seeing improvements each week and by the end of November the experience on the site will be smooth for the vast majority of users,” she said.

She repeated that there were no “high risk” warnings of the site’s problems before it went live Oct. 1. Contractors who worked on HealthCare.gov told a recent House hearing that inadequate testing of the whole site and last minute decision-making by Tavenner’s agency were red flags for website problems.

Tavenner, who was confirmed by the Senate in May with 91 votes, has gotten less political heat than HHS Secretary Kathleen Sebelius, who will testify before the Senate Finance Committee on Wednesday. The CMS chief is closer to the decision-making process– Sebelius pointed to her as the official who make the controversial decision to shut off “window browsing” for health plan options on the website two weeks before enrollment began. But Sebelius is closer to the White House and viewed as more political. Several lawmakers have called for Sebelius to be fired, but so far none have demanded that Tavenner go.